The Psychiatric Consultation Liaison Service (PCLS) serves an important integrative function in the NIH Clinical Center. Perceptive clinicians in the NIH intramural research program interact with the PCLS which leads to unique research collaborations in the areas of psychiatric and psychosocial research in the medically ill. Patient-subjects enrolled in research trials in other Institutes/Centers at the NIH offer unparalleled opportunities to explore the roles of specific genes (e.g., monogenic diseases) and specific therapies (e.g., interferon alpha in hepatitis) in psychiatry and neurodevelopment. PCLS Neuropsychology Consultations, initiated in October, 2008, continue to be an active service, performing about 250 neuropsychological evaluations per year. Two-thirds of these evaluations for neurocognitive phenotyping of medical disorders have been as a result of research collaborations between NIMH and other Institutes such as NIAMS, NHGRI, NIAID. NHLBI, NINDS and others. Recruitment for our suicide screen tool revalidation and suicide screening of medically ill children in a pediatric emergency room (Washington, D.C., Boston, Massachusetts, and Columbus, Ohio) is nearly completed. From a feasibility study of a single emergency department site, 6% of the 106 medical patients who were screened for suicide risk reported clinically significant suicidal ideation. In addition, 96% of the total patients (n = 156) stated that nurses should screen children for suicide risk in the pediatric emergency department. An evaluation of medical record data of a suicide screening tool found that 53% of children under the age of 12 presenting to the emergency department for psychiatric reasons screened positive for suicide risk. Collaboration with mental health and pediatric oncology clinicians has led to the development of a robust research program on psychiatric and psychosocial aspects of pediatric oncology care, culminating in the production of a handbook on psychological and psychiatric aspects of pediatric oncology care. Several protocols studying chronically ill youth are in data-collection phase, including evaluation of a "distress thermometer" in pediatric medically ill populations, characterization of "lone" parenting, and a new protocol on the experiences and needs of international families whose children are in research that is about to begin. In adult oncology, PCLS researchers worked with a multidisciplinary workgroup to redefine the classification of psychiatric events in oncology in clinical trials. An informed consent training video produced by the Clinical Research Advocates (CRAs) of the Human Subjects Protections (HSPU), in the Office of the Clinical Director, will be used for training in all the Graduate Medical Education clinical training programs at the NIH. The CRAs continues to provide training courses as well as present at national meetings on their experiences regarding implementing processes to standardize the evaluation and protection of vulnerable subjects in research. An exciting new NIH initiative spearheaded by the National Institute of Allergy and Infectious Diseases (NIAID) and the D.C. Department of Health (DOH) is the D.C. Partnership for HIV/AIDS Progress (DC PFAP). DC PFAP is designed to both enhance the availability of subspecialty care and to provide access to evidence-based clinical protocols and intramural research protocols. The NIMH PCLS team is an early partner in this important initiative. In conjuction with the D.C. government, local academic institutions, local community providers and HIV/AIDS patients, NIMH will assist in expanding knowledge on psychiatric and behavioral aspects of HIV/AIDS, specifically in D.C., and help to identify the most effective strategies for reducing the impact of psychiatric morbidity of HIV/AIDS in D.C. PCLS research has had a productive year with more than 25 posters, presentations or courses in the past year and the numerous publications listed below.